| NPI | 1720181084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C159591) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101238023) |
| 207Q00000X Family Medicine (Licence: OH 35121711) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2021-07-06 |